Craniosynostosis

Definition

Craniosynostosis is a birth defect that causes one or more of the sutures on a baby's head to close earlier than usual.

The skull of an infant or young child is made up of bony plates that allow for growth of the skull. The borders at which these plates intersect are called sutures or suture lines. The sutures between these bony plates normally close by the time the child is 2 or 3 years old.

Early closing of a suture causes the baby to have an abnormally shaped head.

Alternative Names

Premature closure of sutures

Causes

The cause of craniosynostosis is unknown. Genes may play a role. However, there is usually no family history of the condition.

One type that is passed down through families (inherited) can occur with other health problems, such as seizures, decreased intelligence, and blindness. Genetic disorders commonly linked to craniosynostosis include Crouzon, Apert, Carpenter, Chotzen, and Pfeiffer syndromes.

However, most children with craniosynostosis are otherwise healthy and have normal intelligence.

Symptoms

No "soft spot" (fontanelle) on the newborn's skull

A raised hard ridge along the affected sutures

Unusual head shape

Slow or no increase in the head size over time as the baby grows

Types of craniosynostosis:

Sagittal synostosis (scaphocephaly) is the most common type. It affects the main suture on the very top of the head. The early closing forces the head to grow long and narrow, instead of wide. Babies with this type tend to have a broad forehead. It is more common in boys than girls.

Frontal plagiocephaly is the next most common type. It affects the suture that runs from ear to ear on the top of the head. It is more common in girls.

Metopic synostosis is a rare form that affects the suture close to the forehead. The child's head shape may be described as trigonocephaly. It may range from mild to severe.

Exams and Tests

The doctor will feel the infant's head and perform a physical exam.

The following tests may be done:

Measuring the width of the infant's head

X-rays of the skull

CT scan of the head

Well-child visits are an important part of your child's health care. They allow your doctor or nurse to regularly check the growth of your infant's head over time. This will help identify any problems early.

Treatment

Surgery is done while the baby is still an infant. The goals of surgery are:

Relieve any pressure on the brain

Make sure there is enough room in the skull to allow the brain to properly grow

Improve the appearance of the child's head

Support Groups

Outlook (Prognosis)

How well your child does depends on:

How many sutures are involved

The child's overall health

Children with this condition who have surgery usually do well, especially when the condition is not associated with a genetic syndrome.

Possible Complications

Craniosynostosis results in head deformity that can be severe and permanent if it is not corrected. Increased intracranial pressure, seizures, and developmental delay can occur.

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